A Doctor’s Assessment of Whether Donald Trump’s Health Is ‘Excellent’

Donald J. Trump, the Republican presidential nominee, spoke on Saturday at a campaign event in Colorado Springs.CreditCreditDamon Winter/The New York Times

By Lawrence K. Altman, M.d.

Sept. 18, 2016

WASHINGTON — In releasing a far more sober account of Donald J. Trump’s health on Thursday, his physician provided details to support his view that the Republican nominee for president is overweight but otherwise “is in excellent physical health.”

The new account from Dr. Harold N. Bornstein of Manhattan was in a more conventional style than his unusual letter of last December that offered scant objective data to support his gushing subjective appraisal of Mr. Trump’s health. Mr. Trump, 70, has repeatedly pledged to release a full medical report, as other candidates in recent presidential campaigns have done to help voters judge their ability to bear the stress of the presidency and complete a full term.

Dr. Bornstein’s latest letter, dated Sept. 13, was based on his examinations of Mr. Trump every spring and another physical he reportedly underwent last week. It omitted a number of details that would be part of a customary summary of a patient’s health.

For example, it did not contain results of any tests on Mr. Trump’s kidney function. Yet Dr. Bornstein wrote that Mr. Trump’s liver and thyroid function tests were all in the normal range, as was his prostate specific antigen, or PSA, level of 0.15.

The 2015 letter said Mr. Trump did not use tobacco or alcohol products and had no history of cancer or bone or joint surgery. His only reported surgical operation was an appendectomy at age 10.

Here is an assessment of the medical history Mr. Trump has made public (and here is one of the history that Hillary Clinton, the Democratic presidential nominee, has made public).

Weight and Dietary Health

Mr. Trump is 6-foot-3 and weighs 236 pounds. In his letter of last December, Dr. Bornstein said Mr. Trump had lost “at least 15 pounds” in the previous 12 months. In the new letter, Dr. Bornstein did not state what Mr. Trump had weighed in each of the annual checkups he has conducted since 1980 or any trends over that period of time. Weight is a standard part of a medical checkup.

Mr. Trump, who often eats fast food, says he would like to shed a few pounds. But Dr. Bornstein did not write about Mr. Trump’s overall diet and what nutritional and exercise advice he offered his patient to achieve his weight-reduction goal.

Cardiac Health

Mr. Trump’s blood pressure was normal at 116/70, as were his cardiac tests. The tests included an electrocardiogram, an ultrasound examination of his heart and a chest X-ray. Mr. Trump takes low-dose aspirin to reduce the chances of a heart attack and a drug called rosuvastatin (marketed as Crestor) to lower his cholesterol and other lipids. Dr. Bornstein did not state how high the lipids were before statin therapy. But the levels were in the normal range in the recent tests: cholesterol, 169; HDL cholesterol, 63; LDL cholesterol, 94; triglycerides, 61. Mr. Trump cited no family history of premature heart disease.

According to an algorithm developed by the National Heart, Lung and Blood Institute and known as MESA (for multiethnic study of atherosclerosis), his risk of a heart attack is 0.7 percent for each of the next 10 years. That measure is higher than the less than 0.2 percent for Mrs. Clinton. Because Mr. Trump is taking a statin, another algorithm developed by the American College of Cardiology and American Heart Association does not apply to his case and so cannot be compared with his rival’s.

Dr. Bornstein has described Mr. Trump’s physical strength and stamina as “extraordinary.” But he has provided no objective measurements to support the opinion.

Neurological Assessment

Because Mr. Trump and Mrs. Clinton are in the age range of increased risk for Alzheimer’s disease and other forms of dementia, many experts have urged that they take neuro-cognitive tests and mental status tests that can detect early clues to dementia. Neither Mr. Trump nor Mrs. Clinton has said whether they have taken such tests.

Mr. Trump has said he was “blessed with great genes — both of my parents had very long and productive lives.” Dr. Bornstein wrote that Mr. Trump’s father, Fred Trump, lived into his 90s and his mother into her late 80s. But Dr. Bornstein did not mention that Fred Trump developed Alzheimer’s disease beginning in his late 80s. The genetics of most forms of Alzheimer’s and dementia are not known with certainty. Doctors consider it prudent to be aware of such a risk, and for patients to be checked if specific signs become apparent.

Orthopedic Issues

Dr. Bornstein did not mention any orthopedic problems. Mr. Trump received a draft deferment during the Vietnam War because of a bone spur in his foot. When asked about it last year by reporters, Mr. Trump said he could not recall which foot was afflicted.

Medication and Immunizations

Beyond the aspirin and the statin Mr. Trump takes regularly, he is not on any other medication. Dr. Bornstein did not state whether Mr. Trump is up to date on a standard schedule of immunizations against pneumococcal pneumonia, influenza or other infections.

Correction:

An article on Sept. 19 about Donald J. Trump’s medical history misstated the candidate’s height, as reported in a recent letter from his physician. Mr. Trump is 6-foot-3, not 6-foot-2. The article also misstated, in some editions, Mr. Trump’s prostate specific antigen, or PSA, level. According to the letter, it was 0.15, not 1.5.

A version of this article appears in print on , on Page A12 of the New York edition with the headline: Is Trump in ‘Excellent’ Health? A Doctor’s Assessment of What We Know. Order Reprints | Today’s Paper | Subscribe